How do I renew my license?Dentists must renew their licenses annually on or before their birthday. They are required to submit the appropriate fee and attest to completion of 21 hours of continuing education with each renewal cycle. Refer to WAC 246-817-440 and 246-12 (7) for more information. Please keep your address updated to receive courtesy renewal notices.

Avoid an expired licenseDo not let your license expire. You must make sure we have your renewal before it expires. Otherwise, you will not be allowed to practice. A timely postmark on your renewal will not prevent an expired license. Renewals sent by mail take about two weeks to process.

How long will it take to process my renewal?If you send it by mail it will take about two weeks to update. If you walk the payment in to the front counter it will take about 3-7 business days. This saves mail time and you will receive verification during the visit. The goal is to process all renewals within seven business days after received. This includes payment and processing time.

How do I know what my expiration date is?Your license lists the expiration date. It is your birthday.

How do I request a duplicate copy of my license?Check the fee page to find the correct payment. Send a check or money order payable to the Department of Health. Please note you are requesting a duplicate credential and remember to include your credential number.

If it is within 90 days of your expiration date, you may renew your credential and receive an updated copy.

How do I update my mailing address?All address change requests must be sent in writing. If you are renewing and have received your renewal notice, please complete the address change request on the back of the card.

If you're not renewing or do not have your renewal card, complete the Address Change Form. Be sure to hit "Email" at the bottom of the form to submit your changes.

You must have your current mailing address on file. Otherwise, we cannot send you the courtesy renewal reminder.

The U.S. Postal Service will not forward state mail so it is your responsibility to inform the Customer Service Office of an address change.

What do I need to change my name on my license?Please mail or fax a copy of your certified marriage certificate, divorce decree or court order showing your name change to the Customer Service Office. You will not be sent a credential showing your new name until we have processed your next renewal. You may also include this request when submitting your renewal.

Do I need to send copies of certificates of completion?No. You must sign an affidavit of compliance annually. You will find the affidavit on the back of your annual renewal notice.

How long do I have to keep continuing education documentation?You must keep your documentation for four years.

May I count continuing education hours I accumulate for other sources, (i.e. national certification with specialty organizations, etc.) towards this requirement?Yes.

How many continuing education hours may I obtain online or through correspondence?Seven hours. Law indicates a maximum of seven hours in this category. (WAC 246-817-440 (c))

May I count continuing education hours from one year in the next year?No. You cannot carry over continuing education in excess of the required hours earned in a reporting period to the next reporting cycle. (WAC 246-12-230)

If I administer sedation, am I required to take additional continuing education?Yes.

We want to provide a continuing education course. How do we obtain approval?The commission does not approve or accredit continuing education courses. Law indicates that a credit hour for time actually spent in a course cannot be less than fifty (50) minutes. (WAC 246-12, Part 7) All courses must be designed to enhance the professional development of the dentist or improve the care provided to patients. You may provide a document to the dentists attending your course, stating the name of the course, the date(s) taken, and the total number of continuing education hours completed. Other organizations, such as American Dental Association accredit continuing education courses.

Does my study club have to be recognized by some entity to be considered acceptable?No. Study club hours are an acceptable source of continuing education, provided the coursework is designed to enhance the professional knowledge and development of the practitioner or enhance services provided to patients. We do realize there are various types of study clubs and that some are more social in nature, while others are offered, authorized or accredited by various professional organizations.

One of the dental product vendors wants to come into my office and provide an "in service" training on new dental products and materials, techniques and equipment. Is this acceptable continuing education?Yes. Fifty (50) minutes is a credit hour. You should get some type of documentation of the content of the training, the time spent, etc. for your records. We would consider this, per the rule, as training offered or authorized by an industry recognized private organization or agency.

Explain the volunteer services category – what types of volunteer services are acceptable?The commission recognizes the value of dentists providing volunteer services to targeted populations. The dentist and recipient both benefit. The commission determined that if the dentist obtains some specialized training or education, prior to providing services to a specific population, up to seven continuing education hours could be accumulated per reporting cycle. Examples of this type of continuing education would be working with the Special Olympics, working with the Smilemobile or ABCD programs, etc. Most of these programs provide training/orientation programs to dentists working in these settings. It is not the intention for continuing education hours to be granted for routine pro-bono work that is not preceded by specialized education or instructional training.

May I get an extension of time to complete my continuing education?Dentists may be excused from or granted an extension of continuing education requirements due to illness or other extenuating circumstances. Law requires continuing education to renew your annual license. Any requests should be made several weeks before your renewal date to prevent delays in processing your license renewal. Requests must be in writing and sent to Dental Quality Assurance Commission Program Manager by email or mail. You cannot practice without an active license.

May dentists order lab tests for patients?Yes. Dentists may order lab tests to diagnose and treat dentally related conditions.

Can dentists prescribe Zyban for their patients to assist them in smoking cessation?Yes. Dentists may prescribe smoking cessation products.

When dentists use Triazolam orally on dental patients, is it misleading to advertise as offering sleep dentistry?Yes. Triazolam is typically used as an anti-anxiety medication that may induce sleep in some patients but does not in all. The use of the term sleep dentistry infers that the patient will be asleep.

Is an oral and maxillofacial surgeon with a DDS degree allowed to do elective cosmetic surgery such as rhinoplasty or blepharoplasty?Yes. The definition of oral and maxillofacial surgery does not prohibit the performance of elective cosmetic surgery such as rhinoplasty and blepharoplasty. (RCW 18.32.020)

Treatment facility definition clarification.(WAC 246-817-510)The term connecting suite requires some means of access or passage between suites. Connecting suites would require that a door or passageway be present which would allow treatment providers to walk directly from one suite to the next. The phrase, or the immediately adjacent rooms or areas, refers to adjacent rooms within a particular practice. If there were two separate practices in the same building and they were right next to each other, they would not be considered adjacent rooms or areas. Separate practices within the same medical building that are side by side but do not share a door constitute suites of offices and would not be considered adjoining suites. Offices that share a means of entrance or passage between the practices are considered connecting offices. The term adjoining refers to adjoining rooms within one practice.

The interpretive statement was approved by the commission on July 26, 2013, and filed by the Office of the Code Reviser on August 20, 2013, as WSR 13-17-090.

The use of botulinum toxin injections or dermal fillers in the soft tissues throughout the face can be within the scope of practice of a dentist licensed under chapter 18.32.020 RCW when:

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Used to treat functional or esthetic dental conditions and their direct esthetic consequences

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The treating dentist has appropriate, verifiable training and experience.

The use of botulinum toxin injections or dermal fillers outside the treatment of dental-related conditions for purely cosmetic purposes is not within the scope of practice of dentists not specialty trained as an oral and maxillofacial surgeon. (RCW 18.32.020)

Do all dental offices have to be paperless?The Health Information Technology for Economic and Clinical Health (HITECH) Act requires that healthcare providers who accept Medicare and Medicaid patients/payments change from paper to electronic patient records by 2015. This act is part of the American Recovery and Reinvestment Act (ARRA) of 2009 and has an impact on HIPAA as well. More here: http://www.healthit.gov/policy-researchers-implementers/hitech-act-0

How long must a dentist keep a record?Five years according to the maintenance and retention of records law, WAC 246-817-310.

Does my prescription pad need two signature lines?Yes. RCW 69.41.120 requires that all written prescriptions have two signature lines at opposite ends of the bottom of the form. Under the line at the right side shall be clearly printed the words "DISPENSE AS WRITTEN." Under the line at the left side shall be clearly printed the words "SUBSTITUTION PERMITTED." The practitioner must communicate instructions to the pharmacist by signing the appropriate line. For oral prescriptions, the practitioner or the practitioner's agent must tell the pharmacist whether a therapeutically equivalent generic drug may be substituted. This law includes prescriptions generated electronically.

Do I need to keep a copy of written prescriptions I provide to a dental laboratory or a dental technician?Yes. WAC 246-817-330 indicates an original prescription shall be referred to the dental laboratory or the dental technician and the carbon copy shall be retained for three years by the dentist in an orderly, accessible file and shall be readily available for inspection by the secretary or his/her authorized representative. WAC 246-817-340 requires an accurate record of any medication(s) prescribed or dispensed be clearly indicated on the patient history.

Do I have to post my license in my office?Yes. Dentists, dental hygienists, expanded function dental auxiliaries, and dental assistants must place their license so it is visible to individuals receiving services in the premises. (WAC 246-817-301)

May I advertise through Groupon for my dental office?Although dental laws do not specifically address Groupon or fee splitting, RCW 19.68 prohibits fee splitting by healthcare providers. The American Dental Association (ADA) Principles of Ethics and Code of Professional Conducted states under 4.E. that "dentists shall not accept or tender 'rebates' or 'split fees'" and that this applies to "business dealings between dentists and any third party, not just other dentists." The commission is not aware of the specific contract terms and cannot make a comprehensive determination as to whether Groupon contracts in general violate the anti-rebating statute. If you choose to use Groupon or other like service, it's encouraged that you seek independent counsel to evaluate the actual service contract and associated laws.

Administration of Anesthetic Agents

I administer minimal sedation by inhalation (nitrous oxide), do I need to take additional continuing education?Yes. Law requires seven hours every five years in addition to the annual 21 hours required. (WAC 246-817-740) Continuing education must be in one or more of the following subjects:

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Sedation

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Physiology

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Pharmacology

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Inhalation analgesia

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Patient evaluation

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Patient monitoring

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Medical emergencies

In addition, you must take a healthcare provider basic life support (BLS) or advanced cardiac life support (ACLS) course. You cannot use BLS and ACLS hours for the required seven, but may use it toward annual 21 hours.

I administer minimal sedation, do I need to take additional continuing education?Yes. Law requires seven hours every five years in addition to the annual 21 hours required. (WAC 246-817-745) Continuing education must be in one or more of the following subjects:

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Sedation

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Physiology

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Pharmacology

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Nitrous oxide analgesia

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Patient evaluation

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Patient monitoring

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Medical emergencies

In addition, you must take a healthcare provider basic life support (BLS) or advanced cardiac life support (ACLS) course. You cannot use BLS and ACLS hours for the required seven, but may use it toward annual 21 hours.

I have a Moderate Sedation permit, do I need to have continuing education to renew?Yes. Law requires seven hours every five years in addition to the annual 21 hours required. (WAC 246-817-755) Continuing education must be in one or more of the following subjects:

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Venipuncture

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Intravenous sedation

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Physiology

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Pharmacology

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Nitrous oxide analgesia

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Patient evaluation

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Patient monitoring

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Medical emergencies

In addition, you must take a healthcare provider basic life support (BLS), advanced cardiac life support (ACLS) or pediatric advanced life support (PALS) course. You may not use BLS, ACLS, or PALS hours for the required seven but may use it toward annual 21 hours.

I have a Moderate Sedation with Parenteral Agents permit, do I need to have continuing education to renew?Yes. Law requires 18 hours every three years in addition to the annual 21 hours required. (WAC 246-817-760 ) Continuing education must be in one or more of the following subjects:

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Sedation

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Physiology

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Pharmacology

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Nitrous oxide analgesia

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Patient evaluation

•

Patient monitoring

•

Medical emergencies

In addition, you must take a healthcare provider basic life support (BLS), advanced cardiac life support (ACLS) or pediatric advanced life support (PALS) course. You cannot use BLS, ACLS, or PALS hours for the required 18 but may use it toward annual 21 hours.

I have a General Anesthesia permit, do I have to take continuing education to renew?Yes. Law requires 18 hours every three years in addition to the annual 21 hours required. (WAC 246-817-770) Continuing education must be in one or more of the following subjects:

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General anesthesia

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Conscious sedation

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Physical evaluation

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Medical emergencies

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Pediatric advanced life support (PALS)

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Monitoring and use of monitoring equipment

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Pharmacology of drugs

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Agents used in sedation and anesthesia

In addition, you must take a healthcare provider basic life support (BLS) or advanced cardiac life support (ACLS) course. You cannot use BLS and ACLS hours for the required 18 but may use it toward annual 21 hours.

FAQs

How many hygienists may a dentist supervise?At one time, dentists were only allowed to supervise up to three hygienists. That restriction has been removed from law, so the issue now is a matter of the dentist's judgment regarding professional management.

What procedures can a hygienist perform when a dentist is not in the office?A hygienist, in most practice settings, works under the dentist's close or general supervision. Close supervision means "a dentist [must] be physically present in the treatment facility while the procedures [are] performed" (WAC 246-817-510). General supervision allows a hygienist to perform procedures "based on examination, diagnosis…and instructions given by a licensed dentists…[without] the physical presence of the supervising dentist in the treatment facility" (WAC 246-817-510).

Under state law, a hygienist can perform the following procedures under a dentist's general supervision: oral inspection and measuring of periodontal pockets with no diagnosis, patient education in oral hygiene, taking intra-oral and extra-oral radiographs, applying topical preventive or prophylactic agents, polishing and smoothing restorations, oral prophylaxis and removal of deposits and stains from the surfaces of the teeth, recording health histories, taking and recording blood pressure and vital signs, performing sub-gingival and supra-gingival scaling, performing root planning, and applying sealants (WAC 246-817-550).

What are the requirements for a dental office to terminate care for a patient?According to Washington State law, "The attending dentist, without reasonable cause, shall not neglect, ignore, abandon, or refuse to complete the current procedure for a patient. If the dentist chooses to withdraw responsibility to a patient of record, the dentist shall: (1) Advise the patient that termination of treatment is contemplated and that another dentist should be sought to complete the current procedure and for future care; and (2) advise the patient that the dentist will remain reasonably available under the circumstances for up to 15 days from the date of such notice to render emergency care related to that current procedure" (WAC 246-817-380).

How long are dental offices required to keep patient's records?Both the state and federal governments have laws on healthcare record retention, but the federal law supersedes the state law. The Health Insurance Portability and Accountability Act (HIPAA) requires that all dental records be kept for at least six years after the patient's last visit.

Although the law only requires patients' records be retained for six years, some liability experts recommend that dentist keep records longer. A rule of thumb that is commonly used is the "6-10-21 years" rule, which suggests that dentists keep patients records at the following durations: six years after the death of a patient, 10 years after a patient's last appointment if you are no longer their dentist, and 21 years from the date of a patient's birth if you stop seeing that patient when they're still a minor.

What is an NPI number and am I required to obtain one?The National Provider Identifier (NPI) is a government-issued, standard identification number for individual health care providers, clinics, and group practices. This number will replace social security numbers, individual tax ID numbers and other identifiers on standard electronic health care transactions. Starting on May 23, 2007, any health care provider who uses standard electronic transactions will be required by federal law to start including NPI numbers on all electronic transactions. Although some dental offices are not required to obtain an NPI number, the ADA encourages all providers to obtain a number due to its built in security features and other advantages.

Obtaining an NPI is easy and free. The application can be found here and takes approximately 20 to 30 minutes to complete. Some companies have sent solicitations to dental offices about selling NPI reference materials, but the ADA has emphasized this service is unnecessary.

Additional, information regarding NPI numbers can be found on the ADA website, questions can be answered by email at NPI@ada.org or by phone at 1-800-465-3203.